2 Please note: the VSRC is changing name to become the Transport Safety Research Centre (TSRC) to reflect the broad range of research conducted. Disclaimer Although this report was commissioned by the Department for Transport (DfT), the findings and recommendations are those of the authors and do not necessarily represent the views of the DfT. While the DfT has made every effort to ensure the information in this document is accurate, DfT does not guarantee the accuracy, completeness or usefulness of that information; and it cannot accept liability for any loss or damages of any kind resulting from reliance on the information or guidance this document contains. VSRC, Loughborough University i

3 EXECUTIVE SUMMARY The OTS database was interrogated to facilitate a first look at the types of injury sustained by UK powered two wheeler (PTW) riders and the use of personal protective equipment and its effectiveness. The two study areas of OTS were selected to represent the injury severity and road user distributions of national police reported accidents. Of PTW crashes in the study sample 68% occurred in a 30 and 40mph zone. Most crashes occurred while the PTW was travelling along a straight road and impacted a car. Most riders were male but Mopeds showed the highest proportion of female riders (19%). Mopeds were also ridden by the youngest riders (57% under 20 years old). Road bikes were ridden by the oldest riders (47% were 40+ years old). Road bikes accounted for the largest proportion of injured riders (40%) and those riders seriously injured to the MAIS 3+ level (51%). Compared to the fatality rate of 6% for the whole OTS PTW sample, Road and Sport bikes showed the highest fatality rates of 9% and 8% respectively. Road bikes accounted for 55% of rider fatalities and 40% of all bikes. Sports bikes accounted for 35% of rider fatalities and 30% of all bikes. Thus the fatality rate in respect of exposure was much less for Sports bikes. Mopeds formed 15% of the OTS sample with 0% fatality rate while Large scooters were 9% of the sample with a 2% fatality rate. In PTW crashes, the head and chest were the body regions most at risk of serious injury while the neck, abdomen and pelvis were rarely seriously injured. The arms and legs sustained the highest proportion of slight injuries but 17% of riders sustained AIS 2+ arm injury (mainly fractures) compared to 14% who sustained AIS 2+ leg injury (mainly fractures). The feet were at low risk of sustaining fractures (2% of riders). The majority of significant head injuries (AIS 2+ and AIS 3+) were sustained by Road bike riders, followed by Sport bike riders. Serious head injuries for Moped riders were rare. Road bike riders sustained the most AIS 2+ and 3+ chest injuries whereas no Moped or Large scooter riders sustained chest injuries at those levels. Arm fractures were sustained by roughly equal numbers of Road and Sport bike riders but again, very few by Moped and Large Scooter riders. The majority of leg fractures were sustained by Road bike riders although 15% of leg fractures were accounted for by those riding Mopeds. Foot fracture was again mostly accounted for by Road bike riders (57%). About a third of foot fractures occurred to Sport bike riders with Moped riders sustaining 14% of those injuries. Safety helmets were almost universally used but only around a half of all riders wore protective motorcycle clothing. Most Moped riders wore no protective clothing whatsoever. The use or non-use of protective clothing showed no major effect on the distribution of injury severity in this study sample. To clarify this further, It is recommended that a future study be carried out with non-injured riders because when protection works to the extent that no injury is sustained, such crashes with no injury are not reported to the police. VSRC, Loughborough University ii

7 1. BACKGROUND 1.1. Rationale for the Study Motorcyclists are vulnerable road users. Unlike the occupants of cars, this road user group has little or no passive vehicle crash protection in the form of crumple zones, safety cages and restraint systems so their injury outcome from crashes is often more severe. Motorcyclists for example are 57 times more likely to be killed or seriously injured per kilometre driven compared to a car occupant (The Department for Transport, 2009). Given the difficulty in providing passive protection for motorcyclists, crash prevention is often assumed to be the most effective way to reduce their risk of injury. There are, however, many challenges in providing active safety for motorcyclists. Transferring car technology, such as automatic braking and stability control is challenging because too much intervention could result in a two wheeled vehicle falling over. The EU PISa project (2010) for example was only able to instigate an automatic braking system that reduced crash severity rather than completely preventing a crash. Use of motorcycles is increasing due to rising fuel costs, traffic density and environmental factors and it is timely to re-visit the potential of passive protection for motorcyclists. In terms of passive rider protection, helmet use has been obligatory in the UK since On the other hand, the use of any other personal protective equipment is left to the rider s discretion. Currently, motorcycle mounted airbags, suit mounted airbags, armoured clothing and neck protection devices are available, but are they well utilised and what injuries could they address? Research outlining motorcyclist injury patterns was reported by the European Experimental Vehicles Committee in 1993 and additional research looking at the use of passive protective equipment for motorcyclists was carried out more recently (APROSYS SP4, 2004, ACEM [MAIDS], 2004) but none of these utilised UK data. The UK On-the-Spot Study (OTS), reported by Hill and Cuerden, 2005, records detailed information on motorcycle crashes and gives us the opportunity to chart the types of injuries sustained by motorcyclists in the UK, the causes of injuries and the types of crashes where they occur. The two areas chosen for the OTS study were selected to ensure that, when the data from both areas was combined, the injury severity distribution of road accidents was representative of the severity of accidents occurring nationally and also that the sample was representative of the different road user types. Analysis of this study could allow us to develop a view on what personal protective equipment is most effective and whether requirements for its use need to be developed. UK law specifies the use of protective helmets for motorcyclists and these devices are required to meet minimum performance standards (BS6658, ECE22.05). The effectiveness of helmets in reducing head injury has been well proven (Ankarth et al, 2002). By contrast, the benefit of motorcycle mounted leg protection devices has not been so well substantiated. Rogers, 1991 reporting a large, in-depth series of crash tests of leg protectors suggested that such devices could increase both leg and head injuries, as well as overall injury severity. In more recent work, Rogers and Zellner, 1998, concluded that leg protectors can produce a mixture of beneficial and harmful effects. VSRC, Loughborough University 6

8 Currently, a plethora of passive protection devices exist on the market. Protective boots, suits and gloves abound. High end motorcycle boots usually contain crush resistant soles and ankle protectors but cheaper versions do not. A similar situation exists with gloves, some contain knuckle armour while others are designed merely to resist abrasion. A number of European standards exist for impact protection in rider clothing. EN :1997 Impact protectors worn over rider s elbows, hips, knees and shoulders EN :2003 Impact protectors worn over the rider s back EN 13595:2002 Jackets, trousers plus one-piece and two-piece suits EN 13634:2002 Motorcyclists footwear * EN 13594:2002 Motorcyclists gloves Dedicated shoulder, elbow, hip, knee and leg armour in motorcycle trousers and jackets often conform to European standards. However, non armoured garments are rising in popularity, being more comfortable and generally more stylish. An example being Kevlar lined jeans and jackets from such companies as Draggin Jeans and Red Route. It should be noted that many of these garments can be fitted with armour if required. Traditional leather is also still popular, often without armour, but there is still debate as to whether a leather suit provides better protection against abrasion injuries compared to modern fabric suits. Strap on protection is also now available. Back and chest protection from companies such as Knox and Forcefield are available and neck protection devices developed in MotoGP are available from BMW Motorrad. Passive car technology has also now reached the motorcycle world. Dainese markets an airbag system built into a motorcycle suit while Honda (Honda, 2006) have a bike mounted airbag system designed to keep the rider on the bike during a head on collision. Questions exist concerning how much protection this equipment offers and against which types of injury? How many riders in the real world use this equipment and what equipment do they use? Many of the products are pricey and fall outside of the range of some riders. This may be an issue particularly with younger riders of smaller capacity machines and those who have taken to riding bikes through economic necessity. Knowing more about motorcyclist s injuries and the clothing worn (or not worn) could give insight into what, if anything needs to be done to encourage the use of passive safety protection and what kind of return might be possible in terms of injury reduction Key Research Questions 1. What is the level of use of personal protective equipment - overall and by motorcycle type, rider type? 2. What are the injuries sustained by motorcyclists? 3. What is the effectiveness of personal protective equipment? 4. Is there a need to educate riders in the benefits of personal protective equipment, if so, which riders? VSRC, Loughborough University 7

9 1.3. Methodology The main data source for this study was the UK OTS database. The database at the point of these analyses ( ) contained 8467 vehicles of which 461 (5%) were classed as powered two wheelers (PTW s). These PTW s were ridden by 491 motorcyclists, therefore there were 30 pillion passengers. The 491 motorcyclists sustained between them 1943 injuries of which 571 were at AIS 2+. Numerical analysis of the OTS data were carried out to show the injury patterns of motorcycle casualties in the UK, focusing on injury type, severity, frequency and causation. Additionally, the crash circumstances related to injuries were explored to determine any relationships between injury outcome, injury causation and crash configuration. The use and effectiveness of personal protective equipment was also evaluated. The relationship between rider age and/or type of machine and utilisation of personal protective equipment was also examined Literature Review Crash Helmets - The effectiveness of motorcycle safety helmets in reducing head injury has been well proven. For example Huang & Preston, 2004 showed that helmets reduce the likelihood of death by 29% for all motorcycle crashes. A U.S. study by Coben et al (2007) compared motorcycle-related hospitalisations across states with differing helmet laws. It found that motorcyclists in states without universal helmet laws are more likely to die during hospitalisation, sustain severe traumatic brain injury and be discharged to long-term care facilities. A study by Bachulis et al (reported by Runge, 1997) found that unhelmeted riders were 10 times more likely to require craniotomy (surgical incision through the skull) than their helmeted counterparts. The European MAIDS study (ACEM 2004) found that over 90% of PTW s riders wore helmets but that many severe and fatal injuries are to the head. The COST327 programme stated that head injuries still cause some three-quarters of all fatalities to motorcyclists within Europe, while about one quarter of all injured riders suffer a head injury (Chinn et al 2001). The MAIDS study showed that approximately 10% of crash helmets came off during the accident due to improper fastening or damage during the accident and international studies show that crash helmet use compliance is lowest in southern European countries (Stefan et al 2003). Further research into helmet design is ongoing e.g. Research by Shuaeib et al (2007) into the use of expanded polypropylene (EPP) in achieving multiimpact protection performance as well as improved ventilation. Cervical Spine Brace - This is designed to reduce injury risk to the cervical spine, spinal cord and collar bone resulting from hyperflexion, hyperextension and lateral hyperflexion (overflexion of the head when forced forwards, rearwards and sideways) and also compression of the spinal column due to the effect of force on the helmet. BMW in collaboration with KTM has developed a cervical spine protection system made of carbon fibre, damping material and titanium which aims to reduce the risk of injury to the neck. These spine braces can cost as much as a good helmet. Rider Clothing - The MAIDS study reported that 55.7% of PTW rider and passenger injuries were to the upper and lower extremities, the majority being minor in nature. Appropriate clothing was found to reduce such injuries (ACEM 2004). The APROSYS study found that whilst protective clothing cannot guarantee the reduction of injuries in all accident conditions, it can be stated that this helps to prevent injuries due to abrasions and lacerations, and VSRC, Loughborough University 8

10 reduces the risk of wounds becoming contaminated. A decrease in the severity of sprains and fractures is obtained with the use of protectors (APROSYS D414, 2006). However, A report by the European Experimental Vehicles Committee in 1993 (de Rome and Stanford undated) concluded that protective clothing is less effective in reducing injuries associated with severe bending, crushing and torsional forces to the lower limbs and massive penetrating injuries to any part of the body. Otte et al (2002) in de Rome and Stanford (undated) found that the same level of injury was incurred at lower speeds for non-use of protective clothing than those who did use such clothing (80% at <50km/h without protective clothing compared to 80% at <60km/h with protective clothing). This is reflected in leg injuries e.g. 40% versus 29% injury free between 31-50km/h and it was found that high boots offer significant injury protection. Motorcycle Airbags - The role of motorcycle airbags is to reduce rider injury in frontal collisions by controlling the rider s trajectory and reducing velocity (Finnis, 1990 in Elliott et al, 2003). The APROSYS literature review stated that airbags may be very beneficial in motorcycle accidents providing they arrest rider motion. Tests in the early 1990s showed that full restraint was not possible above a speed of 30 mph, though reducing the rider s velocity and controlling his trajectory could still be beneficial (Elliott et al 2003). Honda has implemented a motorcycle airbag system constituted by four crash sensors mounted on the front fork legs, an electronic control unit (ECU) and the airbag module for its top class touring motorcycle, the Gold Wing. The ECU analyses the signals from the crash sensors to determine whether or not to inflate the airbag. The Honda airbag in horizontal section has a V shape in order to protect the rider even if he is not perfectly aligned with the motorcycle. The Honda airbag is principally designed to mitigate the consequences for the rider when the motorcycle hits the side of a car. In this kind of collision the airbag deploys like a car airbag, except that there is not a restraining system, like a seatbelt, for the rider. For this reason the Honda airbag is much larger than a normal car airbag. Honda investigation of 9 crashes with their airbags found that: the airbag was beneficial in four cases, harmful in two cases and had little or no effect in three cases. The main benefits and risks presented by the system were to the head and neck. In both cases the benefits were shown to outweigh the risks, although by a reduced margin for the neck injuries. However, due to stiffer flexion and extension of the Hybrid III MATD dummy, the benefits may be underestimated. When the injury cost model was applied, it again showed that injury benefits outweighed the risks (Elliott et al 2003) In the mid-1990s, research was undertaken by the Transport Research Laboratory (TRL) in the UK into the development and testing of a purpose built motorcycle airbag restraint system whose objective was to protect the rider in head-on impacts of the motorcycle into stationary and moving vehicles. The system was evaluated for a standard motorcycle with a single 50th percentile rider in the normal seating position travelling at 48km/h head on into the side of a stationary vehicle. Based on the full-scale impact test results analysed to date, the dummy was successfully arrested by the airbag with a reduction in kinetic energy of between 79% and 100%. The neck results for the dummy were significantly less than the tolerance values, representing a major advance over previous research. Based on cost calculations defined in ISO DIS (Motorcycles Test and Analysis procedures for Research Evaluation of Rider Crash Protective Devices Fitted to Motorcycles. Part 8, Documentation and Reports) as applied to the five pairs of ISO tests in the programme, it was shown that the airbag system reduced these costs by 80%. VSRC, Loughborough University 9

11 Rider Airbags - A number of systems have been developed in which the airbag is applied to the rider s clothing rather than the motorcycle. Dainese, a protective sports clothing maker in Vicenza, Italy, employs an electronic computer, powered by a re-chargeable battery and mounted on the motorcycle. It monitors the bike s physical motion and communicates by wireless radio transmission with a receiver in the D-Air vest processing data up to 3,000 times per second. If the computer senses pre-specified, pre-collision activities, such as a sudden deceleration force (about 10g), the D-Air vest is automatically remotely activated. Each of the three bladders can inflate in as little as 30 milliseconds and maintains the pressure for 20 seconds to assist in subsequent impacts. The Eggparka (shock-buffer protection jacket) is triggered when a release switch is activated through the separation of components brought about by the rider disengaging from the machine over a predetermined distance. This causes the small carbon dioxide (CO2) gas cylinder (which is hidden inside the jacket) to release gas into the inner liner of the jacket, inflating bladders around the neck, back and waist within 0.9 seconds, thus adding protection by acting as a "buffer" to absorb the shock of impact. A similar system is used by MotoAir, Taiwan, which uses a coiled cable connecting the rider airbag jacket to the bike. It takes in the order of 8-12kg (17-26lbs) of force on the cable to activate the airbag (so dismounting the bike while plugged in is unlikely to result in activation). VSRC, Loughborough University 10

13 Larger capacity bikes above 500cc form the majority (52%) of the sample whilst the smaller capacity machines (up to 125cc) favoured by learner riders account for some 38%. Machines in the mid range between 125 and 500cc only account for 10% of the sample. The distribution of PTW registration year is shown in table 3. The distribution was calculated from cases where registration year was known. Table 3. PTW Registration Year Year All PTW s (N=441) Pre % % % % % Total 100% By far the largest majority of motorcycles were registered between (48%). The motorcycles most likely to be fitted with current safety technology, such as ABS, linked brakes and traction control would be found in the youngest group of machines, post 2003, which form 20% of the sample. It should be noted however, that currently in 2010, most new motorcycles still do not have these technologies fitted as standard Crash Characteristics Previous motorcycle research has shown that different motorcycles are used in different ways by different riders and this has bearing on the likelihood of a crash as well as the type of crash (Christmas et al, 2009). For further analysis in this study, PTW s were grouped into four main types which together account for 94% of PTW s in the sample. The group classed as Road bike includes roadsters, tourers, cruisers, choppers and adventure bikes which are predominantly used on the road (such as the BMW R1200GS and Suzuki DL650 V-Strom). The second group of PTW s classed as Sport bike includes machines based on race replicas. The third group classed as Moped includes traditional or scooter style machines with up to 50cc engine capacity. The fourth group Large scooters comprises a scooter style machine with engine capacity above 50cc. The new Road bike group accounted for 40% of all bikes, Sport bikes for 30%, Mopeds for 15% and Large scooters for 9%. Table 4 shows the road speed limit at the point of the crash in which these machines were involved. The distributions were calculated from cases where speed limit was known. VSRC, Loughborough University 12

15 All PTW s, irrespective of type interacted predominantly with a car as the first struck object. Man made roadside objects were not a common source of first interaction, although Sports bikes interacted with these objects (15%) more often than other PTW types. Table 6 summarises the pre impact movement for each type of PTW. Data was available for all PTW s in the sample. For all PTW s, by far the most common pre impact movement was driving along a straight road (47%). The second and third most common pre impact movement for all PTW s was overtaking a moving vehicle on the left (14%) and going round a right or left hand bend (13%). The fourth most common movement was going round a roundabout (6%). Given that the most common first object interaction is with another car (Table 5) this would suggest that the most common cause of crashes concerns either a car moving into or stopping in the path of the PTW. Looking at PTW s by individual type showed a broadly similar pattern to that for all PTW s. There were, however, some differences between PTW types. Mopeds were generally less likely to be involved in crashes on bends compared to other PTW types and they were more likely to be involved in crashes going along a straight road. Sport bikes were the most likely to be involved in a crash on a bend (17%). Table 6. Most Common Pre Impact Movement by PTW Type Pre Impact Movement All PTW s N=461 Road bike N=183 Sport bike N=138 Moped N=69 Large scooter N=44 Going along a straight road Overtaking a moving vehicle on the left Going round a right or left hand bend Going round a roundabout 47% 44% 47% 58% 43% 14% 18% 14% 12% 9% 13% 13% 17% 7% 9% 6% 6% 4% 4% 16% Other movements 20% 19% 18% 19% 23% Total 100% 100% 100% 100% 100% VSRC, Loughborough University 14

17 Mopeds had by far the largest proportion of riders under 20 years old (57%) followed by large scooters (24%). Mopeds had the largest proportion of riders under 25 years old (75%) followed by large scooters (50%). Road bikes had the largest proportion of riders over 40 years old (47%) followed by large scooters (38%). Sport bikes had the largest proportion of riders aged 20 to 39 (76%) followed by road bikes (49%) large scooters (38%) and then Mopeds (30%). It appears that Mopeds are ridden by younger riders whilst Roadsters and large scooters are ridden by older riders Use of Personal Protective Equipment. Table 9 shows a summary of the personal protective equipment that is currently available and the body regions which are intended to be protected by each. Table 9. Body Regions Protected by Personal Protective Equipment BODY REGION Head and Face Neck cervical spine inc STNI Shoulder acromion/scapula/acromio clavicular joint Elbow proximal humerus/radius/ulna Hands Thoraco lumbar spine Thorax Abdomen Pelvis (hip) PROTECTIVE EQUIPMENT Motorcycle Helmet Neck brace/airbag Shoulder armour in jacket/airbag Elbow armour in jacket Gloves plus knuckle armour Back protector/airbag Chest protector/airbag Kidney belt Hip armour/airbag Thigh - Knee joint and patella Leg tibia and fibula shaft Ankle/foot (joint) medial and lateral malleoli, calcaneous, talus, cuboid, navicular, tarsals, metatarsals Knee armour Shin armour in trousers and boots Boot malleoli protector/ankle and sole stiffener VSRC, Loughborough University 16

18 It should be noted that no PTW s equipped with airbags were present in the data sample. In addition, most armour in dedicated motorcycle clothing is removable. The database did not contain details on whether armour was fitted to motorcycle clothing. There was, however, information on whether dedicated motorcycle protective equipment was in use at the time of the crash. Table 10 illustrates helmet use and security at the time of each PTW crash by type of PTW ridden. The distributions were calculated from cases where use and security was known. Table 10. Helmet Use and Security Helmet Worn All PTW s N=431 Road bike N=172 Sport bike N=130 Moped N=64 Large scooter N=39 No 5% 5% 4% 6% 3% Yes 95% 95% 96% 94% 97% Total 100% 100% 100% 100% Helmet Security All PTW s N=341 Road bike N=135 Sport bike N=100 Moped N=58 Large scooter N=33 Stayed on 97% 99% 98% 97% 100% Came off 3% 1% 2% 3% - Total 100% 100% 100% 100% Use of an approved motorcycle helmet is a legal requirement in the UK and virtually all types of rider were wearing a helmet. The helmet stayed on the rider s head in almost all cases. Apart from helmets, no other motorcycle protective equipment is mandatory in the UK. Nevertheless, dedicated motorcycle jackets, trousers, gloves and boots are readily available. In the case of jackets and trousers, these usually contain CE approved armour as illustrated in Table 9. Table 11 shows what, if any dedicated motorcycle clothing was employed by riders in this study. The distributions were calculated from cases where use or non use was known. VSRC, Loughborough University 17

20 2.5. Injuries Table 12 shows the distribution of injury severity for all riders. It displays the data as the maximum injury severity for the whole body and then by individual body region. Injury severity in this study was classified according to the Abbreviated Injury Scale or AIS (AAAM 1990). This is an internationally recognised threat to life scale which assigns a severity score of 1 to 6 to an injury: 1 meaning very minor injury with no threat to life and 6 meaning a fatal injury (appendix B). In general, an AIS of 3 or more represents a serious threat to life. For arms and legs, an AIS of 2 or above usually indicates fracture. For some riders, maximum injury severity was unknown and the totals used to calculate percentages in Table 12 are based on known injury severity. Table 12. Maximum AIS by Body Region Maximum AIS Whole Body Head Neck Chest Abdomen Pelvis Arms Legs Feet 0 15% 83% 83% 80% 78% 94% 51% 45% 90% 1 45% 7% 14% 10% 17% 3% 31% 41% 8% 2 19% 2% 1% 1% 4% 2% 14% 7% 2% 3 11% 3% 1% 3% 1% 1% 3% 7% - 4 5% 3% - 4% 1% % 2% - 2% % 1% Total 100% 100% 100% 100% 100% 100% 100% 100% 100% Total N Table 12 demonstrates that 85% of riders in this sample were injured. 45% were injured at the AIS 1 level but 40% were injured at the more serious AIS 2+ level, with 20% being injured at AIS 3+. 6% of all riders were fatally injured. The head and chest were the body regions most at risk of AIS 3+ injury (9% and 9% of riders respectively). The neck was rarely injured seriously. 14% of riders sustained AIS 1 soft tissue neck injury, 1% sustained AIS 2+ and 1% AIS 3+ injury. The abdomen and pelvis rarely sustained life threatening injury, both body regions were injured to AIS 3+ in only 1% and 2% of riders respectively. The arms and legs sustained the highest proportion of AIS 1 only injury (31% and 41% of riders respectively) and these were generally cuts, bruises and abrasions but 17% of riders sustained AIS 2+ arm injuries (94% of which were fractures) compared to 14% who sustained AIS 2+ leg injuries (80% of which were fractures). The feet were at low risk of sustaining fractures (2% of riders). VSRC, Loughborough University 19

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Title SB 57/2014 2 July 2014 Pedal cyclist casualties, 2013 This Statistical Bulletin looks at pedal cyclist road traffic casualties in Wales. It looks both at all pedal cyclist casualties and at child

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